Most people with plantar fasciitis (inflammation of the plantar fascia band causing heel pain) get better with conservative treatments: rest, therapy, orthotics, injections, etc. But there is a stubborn subset – about 5-10% – who have chronic plantar fasciitis (or fasciosis) that lasts more than 6-12 months despite all efforts. If you’re in that small group, you know the drill: every morning hobbling, every run ending in pain, countless treatments tried, maybe even PRP injections or shockwaves, yet the pain still returns.

Plantar fasciotomy (also called plantar fascia release) is a surgical treatment that involves cutting (releasing) part of the plantar fascia to reduce tension and allow it to heal. Essentially, it loosens that tight band so it stops pulling on the heel. This relieves pain and allows the chronic injury to resolve. It’s typically considered after at least 6-12 months of persistent pain that hasn’t improved with non-surgical management. It’s also considered when the pain is severe enough that it’s significantly affecting quality of life (unable to work, exercise, etc.).

In the past, plantar fasciotomy was done with a large incision on the bottom of the foot – painful and long to heal (and you’re cutting weight-bearing tissue). But for many years now, the standard has shifted to minimally invasive techniques. We barely need to open the area, and we certainly avoid a big cut on the sole, just release through a small incision (often on the side of the heel).

Studies have shown 95% patient satisfaction/success with minimally invasive plantar fasciotomy, which is on par or better than open surgery, with far less morbidity. And patients often recover faster, returning to activity sometimes in a matter of weeks rather than months.

• Dr. Patish has extensive experience in treating plantar fasciitis from the conservative to the surgical. He only recommends fasciotomy when it’s truly needed – but when needed, he performs it with expert precision using the latest minimally invasive techniques. We know it can sound scary to “cut” something in your foot, but we ensure you understand it’s a minor snip that yields major results. The procedure’s high success gives us confidence to say: you do not have to live with chronic heel pain forever.

  We also understand you might be apprehensive. That’s why we exhaust other treatments first and make sure you’re truly a candidate. By the time we suggest this, most patients are actually begging for something to end the pain. And we’re happy to deliver that relief.

  In keeping with our style, we keep things positive. We might joke that we’re going to “liberate your fascia” or that we’re performing a “surgical sigh of relief” for your foot. Patients often smile on the day of surgery because they know it’s the last step in a long journey of pain – and better days are ahead.

  If you’re reading this and thinking “this is me, I’ve tried everything and still hurt,” then perhaps it’s time to consider this step.

  Don’t let chronic heel pain stand in the way of your life.

• You’ll finally be giving that overworked plantar fascia a break – literally. What happens after release is that the fascia will scar down a bit in a lengthened state. The relief often isn’t instantaneous (because there’s surgical soreness), but many feel a difference even within days: that deep plantar pain on first step is often markedly reduced. Full benefit can take a few weeks as inflammation subsides and healing occurs.

  Typical milestones:

  • First 1-2 Weeks: Soreness at incision site, manage with pain meds (often just a few days of something stronger, then switch to NSAIDs if allowed). Keep the bandage clean and dry. Elevate your foot to reduce swelling. Start gentle range of motion of ankle (circle, point, flex) to keep limber – no specific plantar fascia stretches yet (we actually want the fascia to heal in a lengthened state without too much tension initially). Partial to full weight-bearing as directed – usually heel weight or flat foot in boot. You might use crutches for balance a couple days then discard as able.
  • 3 Week Follow-up: Remove stitches if not dissolvable. Check incision – usually healed or nearly. We might transition you out of the boot into a sturdy sneaker if you’re comfortable, or give you a softer brace for a bit. We often suggest starting gentle calf stretches around this time, if tolerated, as tight calves often contributed to the problem (and likely we may have done a calf stretch procedure if needed).
  • Weeks 3-6: Increase activity as tolerated. Likely in a normal shoe by end of first month, possibly with an orthotic for support. Begin plantar fascia stretches now (like towel stretch or using a step to stretch the arch) – ironically, the same stretches that hurt before might now feel therapeutic, as the pressure is much less. Some physical therapy might be ordered: ultrasound, massage to the fascia area to prevent any adhesions, strengthening exercises (to ensure arch muscles support foot). If you had any gait changes pre-surgery, we address those. Most people at this stage report something like “I have a little soreness if I’m on my feet all day, but nothing like the sharp pain I used to have.”
  • 2-3 Months: Typically, a final check. By now, you’re likely back to most activities – even running, if that was your goal, often can be resumed around 8-12 weeks post-op with gradual training. We’ll ensure your arch is stable and might recommend an orthotic insert for long-term support (especially if only partial fascia was cut, it’s good to have arch support to assist the remaining fascia). The fascia will have healed in a elongated state, and any tiny gap is filled with scar tissue – which is fine as long as the tension is relieved. The heel bone spur (if present) might still be on X-ray, but if it wasn’t hurting, we don’t mind it remaining as a silent witness to the past problem.

  It’s worth noting: the vast majority of patients have major relief. A few might have minor residual pain – sometimes due to nerve sensitivity or longstanding inflammation that takes time to fully resolve. Occasionally, if only a partial release was done, a small fraction might need further release – but that’s rare, and we tend to release enough initially to avoid that. Conversely, a rare patient might feel a little less arch support (especially if they had a very flat foot to start) – this is why we rarely cut 100% of the fascia, and we may recommend using good supportive insoles after. But overall, it’s life-changing: morning heel pain is gone, they can exercise, stand, even go back to sports pain-free. One patient of ours (an avid runner) after a year of no running, had this done and was running half-marathons again 3 months later – she called it “nothing short of a miracle.”